Improving quality of care through the OECD Patient Reported Indicator Surveys (PaRIS)

1. Measuring healthcare performance through the OECD Patient-Reported Indicator Surveys (PaRIS)

The OECD Patient-Reported Indicator Surveys (PaRIS) assess the performance of healthcare systems in delivering primary care from people’s perspective. Gathering patient-reported data from over 107 000 primary care users linked to more than 1 800 primary care practices across 19 countries, results from Cycle 1 provide comparable evidence on what patients report about their care experiences and health outcomes. Results from Cycle 1 have been widely disseminated through OECD reports, policy papers, and academic papers and additional analytical work is ongoing. In addition, the results have been presented and discussed in various events with policymakers and stakeholders. This chapter outlines the key features of PaRIS, along with its international dissemination and communication activities.

The first cycle of PaRIS collected data in 2023‑2024 from 107 011 patients linked to 1 816 primary care practices across 19 countries, making it the largest international survey of patient-reported outcomes and experiences to date (OECD, 2025[1]). Unlike most existing patient-reported measurement frameworks, which focus on specific conditions or procedures, PaRIS takes a whole‑person, people‑centred approach that considers the ongoing experiences of people living with chronic conditions, who are mainly managed in primary care. PaRIS also links patient-level data with primary care practice characteristics and the health system context through its nested study design, enabling analysis of how primary care delivery and system factors relate to patient outcomes and experiences.

PaRIS focusses exclusively on primary care service users aged 45 years and older who had at least one contact with a primary care practice in the six months preceding sampling. It does not aim to estimate population-level prevalence but to capture the firsthand experiences of those who actively use primary care services, an area that has often not been measured or is poorly understood in many countries.

People living with chronic conditions constitute the largest and fastest-growing group of healthcare users in OECD countries. Primary care serves as the cornerstone of chronic disease management, aiming to provide continuous, co‑ordinated, and comprehensive care over time. By concentrating on a patient group that is universally relevant across health systems, PaRIS enables meaningful international comparisons. These comparisons help identify system strengths and weaknesses, inform policy development and healthcare reforms, and foster the sharing of best practices and innovative solutions across countries.

The first cycle of PaRIS gathered extensive information on the experiences and outcomes of primary care users

The first cycle of PaRIS gathered data from more than 107 000 patients and 1 800 primary care practices across 19 countries and followed a structured collaborative design process (Annex A). By capturing the views of people who interact regularly and recently with primary care, with a focus on people living with chronic conditions, PaRIS provides a detailed picture of how care is organised and functioning from people’s perspective. The breadth and depth of the dataset enable countries to identify policy priorities in their respective countries, while allowing cross-country comparisons with other participating countries.

The insights from PaRIS have the potential to inform a wide range of policy objectives from strengthening primary care delivery to improving digital access, equity, and continuity of care. As the indicators reflect outcomes that matter directly to people, they provide a powerful tool for identifying areas where systems perform well, spotlighting gaps, and guiding reforms aimed at improving responsiveness and quality. Understanding how these data translate into real‑world policy and practice use requires examining how countries have interpreted, communicated, and integrated the findings into their decision‑making processes.

The PaRIS results were discussed at policy dialogues and stakeholder events

The international launch of the PaRIS flagship report marked a key milestone in disseminating results to a global audience. Hosted by the Portuguese Ministry of Health in Lisbon on 20 February 2025, the event convened high-level policymakers, senior health system leaders, healthcare professionals, patient representatives, and researchers from participating countries and beyond. It provided a platform to present the main findings, highlight cross-country comparisons, and initiate policy discussions on how patient-reported data can inform healthcare system performance and people‑centred care. The launch also facilitated media outreach and set the stage for subsequent national and international dissemination activities.

The Secretariat has contributed to a wide range of international conferences, policy forums, and expert meetings to present the PaRIS results and methodological advances. These include OECD Health Committee and Working Party meetings, stakeholder group discussions, and major international conferences in health services research and primary care such as the European Forum for Primary Care and the World Organisation of Family Doctors (WONCA) annual conferences. Through these engagements, the Secretariat has ensured sustained visibility of PaRIS and fostered dialogue on the integration of patient-reported measures into routine healthcare system monitoring.

The Secretariat organised a series of thematic webinars to provide in-depth analysis of key findings. Each webinar focussed on a specific chapter of the flagship report (e.g. multimorbidity, person-centred care, trust, methods and inequalities (planned on 16 April 2026)), allowing for detailed discussion of results, methodological considerations, and policy implications. These webinars targeted policymakers, stakeholders, and researchers, and encouraged interactive exchanges between policymakers, patients and healthcare professionals on how findings can be translated into national policy contexts. Recordings of the webinars are available on the PaRIS website.1

In addition to thematic webinars, dedicated stakeholder webinars were organised to engage specific audiences, including healthcare professionals and patient organisations. These sessions aimed to strengthen understanding of PaRIS concepts by different stakeholders, promote uptake of patient-reported measures, and gather feedback on the future development of the initiative. They also served as a platform to share experiences and good practices. PaRIS findings have been featured in a variety of external events organised by international and national organisations as well as other stakeholders. These include the WONCA World 2025 conference, the 2025 annual conference of European Forum for Primary Care, and several events organised by national health authorities. In several cases, PaRIS results have been used to inform panel discussions, keynote presentations, and workshops on measuring what matters to patients and strengthening people‑centred healthcare systems.

PaRIS data informed OECD publications, policy briefs and academic papers

The PaRIS flagship report, Does healthcare deliver? Results from the Patient-Reported Indicator Surveys (PaRIS), was the main vehicle for disseminating the first set of results. It provides internationally comparable evidence on patient-reported outcomes and experiences in primary care, alongside analyses of inequalities and healthcare system characteristics associated with better performance. The report has been widely disseminated and serves as a reference for policy discussions on people‑centred care.

PaRIS data and insights have been integrated into broader OECD analytical outputs. Selected indicators and findings have contributed to editions of Health at a Glance 2025 (OECD, 2025[2]), enriching the monitoring of healthcare system performance with patient-reported dimensions. In addition, PaRIS results have informed thematic work on chronic conditions, including cardiovascular disease and cancer (OECD, 2025[3]; OECD/European Commission, 2026[4]), by providing complementary evidence on patient experiences and outcomes beyond clinical indicators.

Several OECD policy briefs have drawn on PaRIS findings to highlight actionable insights for policymakers. These briefs focus on topics such as digitalisation in healthcare (OECD, 2026[5]) and prevention and health promotion in cardiovascular diseases (OECD, 2026[6]). They aim to translate complex analytical findings into concise, policy-relevant messages tailored to policymakers.

PaRIS data are expected to contribute to upcoming OECD work streams, including publications on the health workforce, public health, and ageing. In particular, patient-reported measures offer valuable perspectives on primary care workforce performance, responsiveness to the needs of ageing populations and prevention among people with chronic conditions. These forthcoming outputs will further expand the use of PaRIS data to inform cross-cutting policy priorities.

PaRIS data will be made available to support analysis and research. PaRIS‑10 key indicators have been published on the OECD Data Explorer (OECD, 2025[7]). In addition, 13 countries are making their national PaRIS data available as public‑use files to strengthen analytical work and inform policy and research.

A series of analytical papers are also planned. These papers focus on key policy issues, including person-centred care, care co‑ordination, care continuity, multimorbidity (two or more chronic conditions), emergency care, as well as comparative analysis with other international surveys. Such papers target academics, policymakers, healthcare professionals and other stakeholders who are interested in gaining further insights on broader healthcare issues.

Understanding how participating countries have leveraged PaRIS results showcases its added value for national policymaking and informs future cycles

While the international activities are essential in disseminating the PaRIS results to a broad audience, whether PaRIS fulfils its objective of improving healthcare system performance and quality of care will also depend on national activities. “To what extent have these findings been disseminated, communicated, and ultimately used to inform health policy, practice, and decision making at national and local levels” has been the main question guiding this work.

To examine how Cycle 1 findings are being used in the participating countries, the Secretariat conducted semi-structured interviews in March 2026 with representatives from 16 countries (Belgium, Canada, Czechia, Greece, Iceland, Italy, Luxembourg, Norway, Portugal, Romania, Saudi Arabia, Slovenia, Spain, Switzerland, the United States and Wales (United Kingdom) which participated in Cycle 1, complemented by written input from Australia and France (Annex B). The interviews had two main objectives: 1) to examine the policy and practice impact of PaRIS, identifying concrete examples of good practices and 2) to enable cross‑country learning by gathering insights on effective mechanisms that support the dissemination and use of PaRIS data for health policies.

To elucidate how countries are using and applying the PaRIS data, the Secretariat developed a semi-structured interview guide (Annex C) based on Knowledge‑to-Action framework (Graham et al., 2006[8]). The seven‑stage action cycle of the framework which represents the activities that are needed for knowledge application guided the development of the interview guide (Annex D).

This report

This report synthesises early findings from country interviews and provides an initial assessment of how PaRIS Cycle 1 results are shaping health policy and practice. By consolidating national experiences with good practice examples, this report aims to guide further work and inform preparations for future cycles of PaRIS. Section 2 focusses on the dissemination and communication activities; Section 3 on how countries have been using the PaRIS data and results for health policy and practice; Section 4 on sustainability efforts; and Section 5 provides key lessons by analysing the experienced barriers and enablers, and shares recommendations to enhance the use of PaRIS data for health policies.

Note

← 1.  PaRIS website, https://www.oecd.org/en/about/programmes/patient-reported-indicator-surveys-paris.html.